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Color Doppler and spectral Doppler ultrasound detection of active sacroiliitis in spondyloarthritis compared to physical examination as gold standard

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Abstract

Sacroiliac joint (SIJ) involvement is a distinctive feature of spondyloarthritis (SpA). The main objective of this study was to assess the validity of color Doppler ultrasound (CDUS) in SIJ. This was a cross-sectional, blinded, case–control study of 108 cases divided into three groups: (a) 53 SpA patients with inflammatory back pain (IBP); (b) 28 SpA patients with no IBP; and (c) 27 healthy mechanical lumbar pain subjects. Physical examinations of the SIJs were assessed as positive or negative in each SIJ and were used as the gold standard. SIJs were examined with CDUS and spectral Doppler, and the SIJs were assessed as positive when both color Doppler and the resistance index (RI) were less than the cut-off point within the SIJs area. A total of 108 cases (53 female; mean age 36 ± 10 years old) were studied. The physical examination of the SIJs was positive in 38 patients (59 SIJs). Ultrasound detected Doppler signal within the SIJs in 37 cases (58 SIJs): 33 of them had symptomatic SpA (52 SIJs), 3 of them had asymptomatic SpA (5 SIJs), and 1 was a healthy control (1 SIJ). The accuracy of CDUS, when compared to physical SIJ examination, at the patient level in the overall group had a sensitivity of 70.3%, a specificity of 85.7%, a positive likelihood ratio of 4.9, and a negative likelihood ratio of 0.36. For the spectral Doppler RI, with an optimal cut-off point ≤0.75, the sensitivity was 76.2%, and the specificity was 77.8%. CDUS of SIJs seems to be a feasible and valid method for detecting active inflammation in patients with SpA.

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Authors and Affiliations

  1. Rheumatology Department, Hospital Universitario la Paz, Paseo de la Castellana 261, 28046, Madrid, Spain

    Concepción Castillo-Gallego, Eugenio De Miguel, Miriam García-Arias, Chamaida Plasencia, Leticia Lojo-Oliveira & Emilio Martín-Mola

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  1. Concepción Castillo-Gallego
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  2. Eugenio De Miguel
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  3. Miriam García-Arias
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  4. Chamaida Plasencia
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  5. Leticia Lojo-Oliveira
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  6. Emilio Martín-Mola
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Correspondence to Concepción Castillo-Gallego.

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Conflict of interest

C. Castillo-Gallego has received an unrestricted grant from Spanish Foundation of Rheumatology and Pfizer (Esperanza Program).

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All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Castillo-Gallego, C., De Miguel, E., García-Arias, M. et al. Color Doppler and spectral Doppler ultrasound detection of active sacroiliitis in spondyloarthritis compared to physical examination as gold standard. Rheumatol Int 37, 2043–2047 (2017). https://doi.org/10.1007/s00296-017-3813-3

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  • DOI: https://doi.org/10.1007/s00296-017-3813-3

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